Useful hit - add +fs_cachepath X:\folder\path to launch options so that the game allocate cache on HDD instead of creating it dynamically as you go. Eliminates stuttering and improves performance.

Decrease VT pages to 16, turn on CUDA and disable VSync - helps with performance and VT LOD. Of course if you have modern PC, you probably don't need to do that. CUDA acceleration seems to conflict with Vsync, and that produces flickering. So maybe it's useful for everyone with Nvidia.